Neurotoxicology
Philip B. Gorelick, Fernando D. Testai, Graeme J. Hankey, Joanna M. Wardlaw in Hankey's Clinical Neurology, 2020
In the United States alone, there were 2.6 million cases managed in conjunction with poison control centers in 2017. Poison control centers provide care recommendations to both laypersons and health care personnel, and data are collected and summarized via the National Poison Data System. Care of the patient with neurotoxicity should be approached from the framework used in the general care of the poisoned patient. Substances considered benign or therapeutic may become toxic at high doses as is seen with water intoxication, which can present with severe hyponatremia, seizures, and hemolysis. The history of the poisoned patient should include the substance to which the patient was exposed, time of exposure, duration of exposure, route of exposure, and any symptoms experienced since exposure. Assessment of the poisoned patient should always include consideration of decontamination, as this represents a chance to prevent the development of, or worsening of, toxicity.
EEG Maturation with Special Reference to Epileptogenic Effects of Hypoxia
Richard A. Jonas, Jane W. Newburger, Joseph J. Volpe, John W. Kirklin in Brain Injury and Pediatric Cardiac Surgery, 2019
The pattern of electroencephalographic (EEG) activity changes most dramatically in the neonatal period and first year of life, a period of development characterized by multiple maturational events in the brain. The postoperative EEG may be an important tool in assessing neurologic outcome. The prolonged development of myelinated fibers is likely to affect EEG activity. There appears to be a window of vulnerability to the epileptogenic effects of hypoxia. In both animals and humans, stages of EEG development can be approximately related to brain maturation. Clinical observations indicate that the perinatal period represents a window of development in which there is heightened seizure susceptibility. The predominant excitatory amino acid in the brain is glutamate, and certain glutamate antagonists prevent glutamate-induced neurotoxicity. The cumulative effect of the maturational changes in receptor densities and subunit composition, as well as ion metabolism, may increase intracellular calcium concentration.
Efficacy and Cost-Effectiveness Treatment for Chronic Pain: An Analysis and Evidence-Based Synthesis
John D. Loeser in Chronic Pain Management, 2007
This chapter reviews the evidence of the prevalence and for the clinical effectiveness and cost-effectiveness of treatments for chronic pain patients. Chronic and recurring pains are significant problems for a substantial portion of the world population. The direct costs for the totality of the approaches are astronomical and underscore the extremes undertaken to ward off the human suffering associated with chronic pain. Health-care expenditures comprise only a portion of the costs associated with chronic pain. The majority of the costs are associated with disability compensation, lost productivity, and lost tax revenue, among others. Long-term use of medication raises concerns about tolerance, tolerability, drug misuse and abuse and side effects including neurotoxicity. Studies of chronic pain patients taking opioids on a long-term basis suggest that over 45% may be engaging in aberrant drug-taking behaviors. Many treatments for chronic pain may actually increase rather than decrease healthcare utilization. For example, placing patients on long-term opioids requires additional medical monitoring.
An integrative translational framework for chemical induced neurotoxicity – a systematic review
Published in Critical Reviews in Toxicology, 2020
Deepika Deepika, Raju Prasad Sharma, Marta Schuhmacher, Vikas Kumar
Many chemicals in day-to-day and industrial usage have the ability to cross the blood–brain barrier and develop neurotoxicity in humans. There are numerous in vitro, in vivo, epidemiological and in silico studies developed to test the neurotoxicity of such chemicals. This systematic review summarized the endpoints and biochemical markers generated from in vitro models, organism-based models, human studies and in silico tools and how they are used to translate the data for risk assessment of neurotoxic chemicals. Increased evidence about different biomarkers through genomics and proteomics has developed data related to genes and proteins facilitating some understanding about the molecular mechanism of neurotoxicity. Fluid-based biomarkers such as those found in serum, plasma and urine from human studies act as indirect endpoints for neurotoxicity. Meanwhile, with improvement in knowledge of molecular mechanisms and different biomarkers, there is a potential to develop a translational platform that can integrate the biological data from different studies mechanistically and thereby translated across intra and interspecies for neurotoxicity assessment. Further, this review proposed an integrative translational framework combining experimental and in silico studies like toxicokinetic models and integrative systems biology to assess the chemicals for neurotoxicity. This framework can be used to predict the inherent risk of neurotoxicity and extend to such chemicals where less experimental data exists.
A Pilot Study of Symptoms of Neurotoxicity and Injury among Adolescent Farmworkers in Starr County, Texas
Published in International Journal of Occupational and Environmental Health, 2010
Kristina W. Whitworth, Eva M. Shipp, Sharon P. Cooper, Deborah J. Del Junco
Little is known regarding the relationship between neurotoxicity symptoms and injury, particularly among adolescent farmworkers. This pilot study utilized logistic regression to analyze injury prevalence in relation to self-reported symptoms of neurotoxicity among adolescent farmworkers along the US-Mexico border in Texas. Respondents reporting at least five symptoms had 8.75 (95%CI, 1.89–40.54) times the prevalence of injury compared with those reporting zero or one symptom. Significant associations were observed for six items: trouble remembering things, family noticing memory loss, making notes, irritated for no reason, heart pounding, and tingling. This pilot study suggests a relationship between symptoms of neurotoxicity and injury among adolescent farmworkers, supporting the need for more rigorous investigations.
A comparison of the ability of newly-developed bispyridinium oxime K203 and currently available oximes (trimedoxime, obidoxime, HI-6) to counteract the acute neurotoxicity of soman in rats
Published in Toxicology Mechanisms and Methods, 2010
Jiri Kassa, Jana Zdarova Karasova, Sandra Tesarova, Kamil Kuca, Kamil Musilek
The neuroprotective effects of newly-developed oxime K203 and currently available oximes (trimedoxime, obidoxime, HI-6) in combination with atropine in rats poisoned with soman were studied. The soman-induced neurotoxicity was monitored using a functional observational battery at 24 h following soman challenge. The results indicate that the potency of a newly-developed oxime K203 to counteract soman-induced neurotoxicity is very low and roughly corresponds to the neuroprotective efficacy of currently available oximes. Among tested oximes, the oxime HI-6 seems to be the most efficacious to counteract acute neurotoxicity of soman, although the differences in neuroprotective efficacy of chosen oximes are not significant. Thus, the oxime K203 does not provide any beneficial effect for the antidotal treatment of acute poisoning with soman and the oxime HI-6 should be still considered to be the best oxime for antidotal treatment of acute soman poisonings.
Related Knowledge Centers
- Cancer Chemotherapy
- Nervous System
- Neuron
- Radiation Therapy
- Pharmacotherapy
- Organ Transplant
- Brain Damage